CR 18-071 Rule Text

- The dispensing or prescribing of drugs or medicine.

- Except for diagnostic purposes only, the use of x-ray.

- The performance of an invasive procedure involving a body orifice or cavity unless allowed by rule and limited to examinations involving the ears, nose, and throat.

- The treatment of fractures or dislocations.

Rules of the Michigan Department of Licensing and Regulatory Affairs specify the criteria and requirements for adjustment apparatus, analytical instruments, performance or ordering of tests, and performance of invasive procedure (Mich Admin Code, R 338.12010, R 338.12011, R 338.12011a, and R 338.12011b).

Minnesota: Minnesota statutes address the scope of chiropractic practice through a definition of “chiropractic services” (Minnesota Statutes 2016, subdivision 1 of section 148.01). Chiropractic services are defined as “the evaluation and facilitation of structural, biomechanical, and neurological function and integrity through the use of adjustment, manipulation, mobilization, or other procedures accomplished by manual or mechanical forces applied to bones or joints and their related soft tissues for correction of vertebral subluxation, other abnormal articulations, neurological disturbances, structural alterations, or biomechanical alterations, and includes, but is not limited to, manual therapy and mechanical therapy as defined in section 146.23.”

An individual licensed to practice chiropractic is authorized to perform chiropractic services, acupuncture, and therapeutic services, and to provide diagnosis and to render opinions pertaining to those services for the purpose of determining a course of action in the best interests of the patient, such as a treatment plan, appropriate referral, or both. The practice of chiropractic is not the practice of medicine, surgery, osteopathic medicine, or physical therapy. (Minnesota Statutes 2016, subdivisions 3 and 4 of section 148.01).

Rules of the Minnesota Board of Chiropractic Examiners provide a chiropractor is engaged in the practice of chiropractic when the chiropractor provides examination or treatment services and the patient, or a person authorized to act for the patient, accepts the services provided (Minnesota Rules, part 2500.6000).

Summary of factual data and analytical methodologies:

The rules were developed by reviewing the provisions of ch. Chir 4 to ensure the rules are consistent with current professional practices and standards and applicable Wisconsin statutes. No additional factual data or analytical methodologies were used to develop the rules.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:

The rules were posted for a period of 14 days to solicit public comment on economic impact, including how the proposed rules may affect businesses, local government units, and individuals. No comments were received.

Fiscal Estimate and Economic Impact Analysis:

The Fiscal Estimate and Economic Impact Analysis document is attached.

Effect on small business:

These rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Agency contact person:

Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone [phone]; email at [e-mail].

Place where comments are to be submitted and deadline for submission:

Comments may be submitted to Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, 1400 East Washington Avenue, Room 151, P.O. Box 8366, Madison, WI 53708-8935, or by email to [e-mail]. Comments must be received at or before the public hearing to be held at 8:30 a.m. on November 29, 2018, to be included in the record of rule-making proceedings.

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TEXT OF RULE

Section 1.   Chir 4.01 is amended to read:

  Chir 4.01 Authority and purpose. This chapter is adopted under authority in ss. 15.08 (5) (b), and 227.11, Stats., and ch. 446, Stats., to interpret the statutory definition of chiropractic practice specified in s. 446.01 (2), Stats. establish standards for the practice of chiropractic.  

Section 2.   Chir 4.02 (1) is repealed and recreated to read:

  Chir 4.02 (1) “Chiropractic science" means the body of organized knowledge related to identifying the cause of departure from health of the patient and the treatment of such conditions without use of drugs or surgery. “Chiropractic science” includes using patient examination to create a diagnosis that serves as a basis for forming clinical judgments of a patient’s condition, degree or nature of treatment needed, and management and rehabilitation necessary for the restoration and preservation of health.

Section 3.   Chir 4.02 (1m) is created to read:

  Chir 4.02 (1m) “Examination" includes any of the following:

  (a) Patient history.

  (b) Evaluation techniques.

  (c) Lab analysis.

  (d) Use of analytical instruments to determine vital signs and screen health status.

  (e) Orthopedic and neurological testing.

  (f) Range of motion and muscle testing.

  (g) Diagnostic evaluation or imaging of the body.

Section 4.   Chir 4.02 (2) is amended to read:

  Chir 4.02 (2) “Instrument" means a device employed or applied in accordance with the principles and techniques of chiropractic science, which is used in the practice of chiropractic to diagnose, analyze, treat, or prevent the cause of departure from complete health and proper condition of the human patient.

Section 5.   Chir 4.02 (3) to (5) are created to read:

  Chir 4.02 (3) “Physiotherapy” has the meaning given “physiotherapy treatment” in s. Chir 10.01 (1r).

  (4) “Practice of chiropractic” has the meaning given in s. 446.01 (2), Stats.

  (5) “Treatment” includes any of the following:

  (a) Adjustment or manipulation of the spinal column, skeletal articulations, and adjacent tissue.

  (b) Physiotherapy and exercise rehabilitation.

  (c) Education, lifestyle modification, and counseling.

Section 6.   Chir 4.03 is repealed.

Section 7.   Chir 4.04 (2) (a) is amended to read:

  Chir 4.04 (2) (a) X-ray procedures that require introduction of drugs, clinical dyes, or radioactive substances;.

Section 8.   Chir 4.04 (Note) is repealed.

Section 9.   Chir 4.05 (1) (intro.) is renumbered Chir 4.05 (intro.) and amended to read:

  Chir 4.05 (intro.)  Scope of practice. A person who holds a license to practice chiropractic licensed under ch. 446, Stats., may engage in the practice of chiropractic, as described in s. Chir 4.03. A license to practice chiropractic does not authorize the license holder to engage in practice beyond the scope of chiropractic the practice, as described in s. Chir 4.03 of chiropractic. Practice beyond the scope of the practice of chiropractic includes, but is not limited to, all of the following:

Section 10.   Chir 4.05 (1) (a) to (d) and (2) (intro.) and (a) to (d) are repealed.

Section 11.   Chir 4.05 (2) (e) (intro.) is renumbered Chir 4.05 (1m) and amended to read:

  Chir 4.05 (1m) The use of any device instrument in the practice of chiropractic to diagnose, analyze, treat, or prevent the cause of departure from complete health and proper condition of the human patient, which is not employed or applied in accordance with the principles and techniques of chiropractic science is prohibited. Such devices include, but are not limited to:.

Section 12.   Chir 4.05 (2) (e) 1. is repealed.

Section 13.   Chir 4.05 (2) (f) to (h) are renumbered Chir 4.05 (2m) to (4) and amended to read:

  Chir 4.05 (2m) Any practice system, analysis, method, or protocol which that does not include the competent assessment, evaluation, or diagnosis of the condition to be treated before beginning treatment of the patient.

  (3) Any practice system, analysis, method, or protocol which that relies upon diagnostic methods that are not generally recognized or accepted within the profession or which do not have scientific validity.

  (4) Any practice system, analysis, method, or protocol which that is represented as a means of attaining spiritual growth, spiritual comfort, or spiritual well-being.

Section 14.   Chir 4.07 (1) is amended to read:

  Chir 4.07 (1) Perform any of the functions in s. Chir 4.03 Engage in the practice of chiropractic.

Section 15. Effective date. The rules adopted in this order shall take effect on the first day of the month following publication in the Wisconsin Administrative Register, pursuant to s. 227.22 (2) (intro.), Stats.

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(END OF TEXT OF RULE)

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